NPI | 1063890929 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A161980) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD465294) |
Enumeration Date | 2015-05-12 |
Last Update Date | 2021-10-05 |