| NPI | 1659930824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A184908) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV LL3244) |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2025-07-18 |