| NPI | 1912163619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A127118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 48501) |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2020-06-03 |