| NPI | 1629567490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-22008) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A174363) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2021-12-15 |