| NPI | 1255305678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A52037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A52037) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2023-01-27 |