| NPI | 1871936534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 171530) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 285092-1) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2023-09-17 |