| NPI | 1063416840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A101291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0060512) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2021-03-31 |