| NPI | 1659958304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 11022539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95016927) |
| Enumeration Date | 2021-03-27 |
| Last Update Date | 2024-01-10 |