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 |