| NPI | 1083092753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16453) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016449) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2021-03-31 |