| NPI | 1245724061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A174303) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116031973) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2024-08-02 |