| NPI | 1134309958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 136900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM NM97-193) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2025-01-15 |