| NPI | 1053301051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C164590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301075468) |
| 207Q00000X Family Medicine (Licence: MA MA229851) | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2023-11-03 |