| NPI | 1053773754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95003939) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA 95003939) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-01-15 |