| NPI | 1912062480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 59280) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C134094) |
| 207Q00000X Family Medicine (Licence: MD D73655) | |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2021-01-19 |