| NPI | 1164633806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A114203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 254734) |
| 207Q00000X Family Medicine (Licence: WA ML20008551) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2019-02-06 |