| NPI | 1609201417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16308) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS12358) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2024-05-06 |