| NPI | 1114763554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: CA 65032) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2025-07-01 |