| NPI | 1740626571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A167809) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 266548) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2020-03-05 |