| NPI | 1699186957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101025214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 14595) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2020-04-15 |