| NPI | 1467595520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A98522) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A98522) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2022-05-13 |