| NPI | 1114907656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200900657) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A92672) |
| 207Q00000X Family Medicine (Licence: NC 2009-00657) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2022-02-25 |