| NPI | 1770045569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A19902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI FS9985271) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2022-08-06 |