| NPI | 1073035440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 169683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351027611) |
| 207Q00000X Family Medicine (Licence: MI 4301113402) | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2020-09-17 |