| NPI | 1821664053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A198772) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT223239) |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2025-01-08 |