| NPI | 1770931578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C199438) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C1-0024295) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2025-09-15 |