NPI | 1588001622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 133043) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 20118) |
Enumeration Date | 2013-05-30 |
Last Update Date | 2022-10-06 |