| NPI | 1851635858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 136187) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.208200) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-01-18 |