| NPI | 1902225816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 18396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG167648) |
| 207Q00000X Family Medicine (Licence: RI DO00904) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2021-03-11 |