| 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 |