| NPI | 1770746653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A111903) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 258344) |
| 207Q00000X Family Medicine (Licence: NM MD2011-0533) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-01-06 |