| NPI | 1669566451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD170080) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A91068) |
| 207Q00000X Family Medicine (Licence: WA MD60682946) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2026-07-06 |