| NPI | 1316051410 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD177448)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A92245)  | 
| Enumeration Date | 2006-08-18 | 
| Last Update Date | 2020-10-19 |