| NPI | 1003846510 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16118) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A7006) | 
| Enumeration Date | 2006-07-03 | 
| Last Update Date | 2020-12-28 |