| NPI | 1548673239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A154509) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 260197) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2018-10-25 |