| NPI | 1316328875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 18262) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 18262) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT016411) | |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2022-01-10 |