| NPI | 1063626711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A117903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 54791) |
| 207Q00000X Family Medicine (Licence: MI 4301085828) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-11-29 |