| NPI | 1831304880 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 30551) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A93823) | 
| Enumeration Date | 2007-05-13 | 
| Last Update Date | 2025-10-15 |