| NPI | 1922291020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A11351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017533) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2021-12-22 |