| NPI | 1700112588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A61408) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301505119) |
| 207Q00000X Family Medicine (Licence: CA A61048) | |
| 208000000X Pediatrics (Licence: CA A61408) | |
| 261QP2300X Clinic/Center Primary Care (Licence: CA A61408) | |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2023-05-04 |