| NPI | 1962447425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A81328) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60588420) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2026-02-19 |