| NPI | 1114158086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A130210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301094259) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2015-11-10 |