| NPI | 1114310687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO4050) |
| 207Q00000X Family Medicine (Licence: IL 036.168513) | |
| 207Q00000X Family Medicine (Licence: NV CL0360) | |
| 207Q00000X Family Medicine (Licence: VT 162.0000232) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2024-10-30 |