| NPI | 1952613762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-16722) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 46005) |
| 207Q00000X Family Medicine (Licence: CA A124733) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2022-09-12 |