| NPI | 1659626711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A155813) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015023153) |
| 207Q00000X Family Medicine (Licence: ND 13539) | |
| 207Q00000X Family Medicine (Licence: ND RL12319) | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2018-10-30 |