| NPI | 1689971814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A150338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 59752) |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2023-05-19 |