| NPI | 1831377175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO157543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A5636) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2021-07-01 |