| NPI | 1629109335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: OR DO165463) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 20A6318) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2022-11-29 |