| NPI | 1750637021 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C186667)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 59886-20)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 4088)  | |
| Enumeration Date | 2012-07-24 | 
| Last Update Date | 2024-02-01 |