| NPI | 1346655230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A142807) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: CA A142807) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2020-07-07 |