| NPI | 1780826792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA md441837) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A107142) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2021-03-30 |