| NPI | 1104975523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 1101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A5195) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |