| NPI | 1417228644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G076534) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CA G076534) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2020-05-12 |