| NPI | 1205326436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QD0401X (Licence: CA 20A19835) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A19835) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2026-02-16 |