| NPI | 1972955755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C168939) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 313320) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2025-06-26 |