| NPI | 1467804930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A169409) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT211982) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2022-12-20 |