| NPI | 1790004091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 152752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101257685) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2021-08-06 |