| NPI | 1306882030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C52847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD-067921-L) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2021-12-22 |