| NPI | 1912269408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME T1279) |
| 207Q00000X Family Medicine (Licence: NM A-1905-15) | |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2023-05-16 |