NPI | 1619195625 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: CA a55301a) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A55301) |
207QA0000X Family Medicine, Adolescent Medicine (Licence: CA A55301) | |
207QA0505X Family Medicine, Adult Medicine (Licence: CA A55301) | |
208000000X Pediatrics (Licence: CA A53301) | |
Enumeration Date | 2007-04-23 |
Last Update Date | 2023-03-07 |