| NPI | 1285631655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD179925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G51322) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2020-01-23 |