| NPI | 1588648208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD27129) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C54649) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2017-03-17 |