| NPI | 1952657074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 078520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A127566) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2021-07-15 |