| NPI | 1831674233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95010179) |
| Additional Taxonomies | 208VP0000X (Licence: CA 95010179) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2018-10-02 |