| NPI | 1053324624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD156899) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A82578) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2023-03-07 |