| NPI | 1609361765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A174685) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301116090) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2022-09-13 |