NPI | 1386177293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208D00000X General Practice (Licence: CA A166917) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61131141) |
Enumeration Date | 2017-04-07 |
Last Update Date | 2023-01-05 |