| NPI | 1528489770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 90653) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A151058) |
| 207Q00000X Family Medicine (Licence: NY 318724) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2024-01-16 |