| NPI | 1891058038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 135512) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 022211) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2025-10-27 |