| NPI | 1770788879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 29780)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A127564)  | 
| 207Q00000X Family Medicine (Licence: SC LL29780)  | |
| Enumeration Date | 2007-06-19 | 
| Last Update Date | 2025-10-15 |