| NPI | 1619668324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A25313) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R4034) |
| Enumeration Date | 2023-05-15 |
| Last Update Date | 2026-06-10 |