| NPI | 1053607119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A128241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R72495) |
| 207Q00000X Family Medicine (Licence: HI 18078) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-10-24 |