| NPI | 1790262210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 19474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020971) |
| 207Q00000X Family Medicine (Licence: PA OT018886) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2022-07-01 |