| NPI | 1619388972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 152024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A152024) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2022-07-08 |