| NPI | 1679860142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C159091) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301098534) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-08-08 |