| NPI | 1528353083 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A129838) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 248645) | 
| Enumeration Date | 2011-06-13 | 
| Last Update Date | 2025-07-23 |