| NPI | 1780972927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A11632) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A11623) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2016-04-27 |