| NPI | 1619223393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 136163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A136163) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2021-08-12 |