| NPI | 1992706394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203914) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20AF239) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-02-27 |