| NPI | 1982947610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 074676) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 16564) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2025-08-25 |