| NPI | 1184669871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A6672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20a6672) |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA 20A6672) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2022-08-04 |