| NPI | 1669766473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 130224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-07693) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2016-11-29 |