| NPI | 1336717206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A193273) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA PTL6835) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-07-29 |