| NPI | 1407210768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A169012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 82249) |
| 207Q00000X Family Medicine (Licence: NC 2017-01980) | |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2020-07-28 |