| NPI | 1194790774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A99957) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238121) |
| 207Q00000X Family Medicine (Licence: OH 35086638) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2025-12-15 |