| NPI | 1053310946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A98361) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101237526) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2015-09-01 |