| NPI | 1811296288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 14479) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A14479) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2021-05-18 |