| NPI | 1528351459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A124126)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2011-05-25 | 
| Last Update Date | 2024-11-13 |