| NPI | 1659415123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D66660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A104638) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2015-02-04 |