| NPI | 1972789717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C168263) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 81022) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2022-02-04 |