| NPI | 1407200942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 17478) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT016999) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2019-08-02 |