| NPI | 1174962898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A158762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301103389) |
| Enumeration Date | 2013-06-15 |
| Last Update Date | 2019-11-29 |