| NPI | 1689085524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA DO034705) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102205159) |
| 207Q00000X Family Medicine (Licence: DC DO034705) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2021-05-14 |