| NPI | 1780116707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 170027) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 271317) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2021-02-19 |