| NPI | 1356509608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA c139910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 255306) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2020-11-14 |