| NPI | 1962599720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 66309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 68166) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-03-31 |