| NPI | 1336708064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A19368) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: CA 20A19368) |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2024-03-11 |