| NPI | 1063894905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A154687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107848) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2023-03-27 |