| NPI | 1255610465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A129354) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 6471) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2021-05-04 |