| NPI | 1750933248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351044816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 182733) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2022-10-11 |