| NPI | 1013306752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 73015) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A66699) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2016-02-12 |