| NPI | 1972629020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A12566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS5170) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2019-01-16 |