| NPI | 1871636639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A12947) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101013955) |
| 207Q00000X Family Medicine (Licence: IL 036-104526) | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2021-11-29 |