| NPI | 1053761403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A193116) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 30245) |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2024-09-27 |