| NPI | 1730874462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A206875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA HS000015) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2026-06-29 |