| NPI | 1811627276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A197474) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351050320) |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2026-02-25 |