| NPI | 1770788879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 29780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A127564) |
| 207Q00000X Family Medicine (Licence: SC LL29780) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2025-10-15 |