| NPI | 1811569056 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A23121) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO3725) | 
| Enumeration Date | 2021-07-16 | 
| Last Update Date | 2025-09-22 |