| NPI | 1619195625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA a55301a) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A55301) |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA A55301) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CA A55301) | |
| 208000000X Pediatrics (Licence: CA A53301) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2023-03-07 |