| NPI | 1073264321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 95015487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 218659) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2023-02-03 |