| NPI | 1831481639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA c167719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 58711) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-12-17 |