| NPI | 1619318532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 275039) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A136805) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2018-09-15 |