| NPI | 1740515030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GU M-1653) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A106667) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2020-12-07 |