| NPI | 1730483033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 53527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20a11504) |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2023-11-27 |