| NPI | 1962082503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD224763) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A192428) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-07-15 |