| NPI | 1386056703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD219696) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A139230) |
| 207Q00000X Family Medicine (Licence: CA 139230) | |
| 207Q00000X Family Medicine (Licence: WA MD60957467) | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2025-09-08 |