| NPI | 1790206407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A169547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7970) |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2020-07-30 |