| NPI | 1174544027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 77621) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 2OA6216) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2025-05-14 |