| NPI | 1740579754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A13533) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 102858) |
| 207Q00000X Family Medicine (Licence: NV DO1884) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2022-04-26 |