| NPI | 1811125099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 600722) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 18205) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2025-09-17 |