| NPI | 1235795790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A20123) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV SL1452) |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2022-12-06 |