| NPI | 1598059651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 260946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A146262) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2017-02-01 |