| NPI | 1104885094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G51394) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 45395) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2014-05-28 |