| NPI | 1134389026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A117712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT193002) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2020-12-11 |