| NPI | 1124447552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C182428) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101259157) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-11-28 |