| NPI | 1750584983 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 138130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 044920) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2021-11-18 |