| NPI | 1336189091 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C144613)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000036548)  | 
| Enumeration Date | 2006-06-08 | 
| Last Update Date | 2022-04-12 |