| NPI | 1114457025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16691) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO4966) |
| 207Q00000X Family Medicine (Licence: FL OS14968) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2021-11-05 |