| NPI | 1578646998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G57232) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 55601) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2018-03-21 |