| NPI | 1386969640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS13664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A10946) |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2021-09-23 |