| NPI | 1154332047 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A55790) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60467089) | 
| Enumeration Date | 2006-08-10 | 
| Last Update Date | 2024-04-17 |