| NPI | 1093076267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A148019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202067) |
| 207Q00000X Family Medicine (Licence: CT 54656) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2020-02-03 |