| NPI | 1942498159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A130678) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL ae38738983415) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2021-11-10 |