| NPI | 1710369186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A171253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301107952) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-03-01 |