| NPI | 1316937261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C132628) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD069328L) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-02-11 |