| NPI | 1124692256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA PA59485) |
| Additional Taxonomies | 208800000X Urology (Licence: CA PA59485) |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-13 |