| NPI | 1174971196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A159480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 110431) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-08-12 |