| NPI | 1619068103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C146662) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238261) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-07-21 |