| NPI | 1750655668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A120236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2013-0761) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2022-07-21 |