| NPI | 1912961913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A55092) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A56092) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2025-11-13 |