| NPI | 1144686684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 43545) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A41337) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2020-09-09 |