| NPI | 1649848524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A187564) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 102899) |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-03-26 |