| NPI | 1699113829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A14644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV SL0952) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-06-22 |