| NPI | 1104860519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD25688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G69727) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2026-04-27 |