| NPI | 1578667077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C137521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9700473) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2016-01-13 |