NPI | 1205984689 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A97808) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A97808) |
305R00000X Preferred Provider Organization (Licence: CA A97808) | |
Enumeration Date | 2007-01-08 |
Last Update Date | 2022-06-22 |