| NPI | 1073967394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A161724) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 207Q00000X) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2019-08-20 |