| NPI | 1386177293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A166917) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61131141) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-01-05 |