| NPI | 1619296340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A118019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-R-8813) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2021-02-08 |