| NPI | 1730125295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101239167) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A81014) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2022-07-21 |