| NPI | 1013620939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 95024376) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA 95024376) |
| 207Q00000X Family Medicine (Licence: CA 95024376) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95024376) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 95024376) | |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2026-09-30 |