| NPI | 1821455510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 31694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95003395) |
| Enumeration Date | 2016-01-26 |
| Last Update Date | 2023-03-29 |