| NPI | 1639323553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA a127700) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2014-0002) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2021-12-08 |