| NPI | 1205176617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 213333) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A12588) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2025-01-08 |