| 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 |