| NPI | 1730455932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A163222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 61381) |
| 207Q00000X Family Medicine (Licence: MO 2015015606) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2024-04-16 |