| NPI | 1073596672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD19570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A95618) |
| 207Q00000X Family Medicine (Licence: MA 223816) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2023-03-16 |