| NPI | 1306918073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102202756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A7799) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-08-10 |