| NPI | 1356637359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A144026) |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO 11-156) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-03-07 |