| NPI | 1124048202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C129686) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 48387) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2014-09-25 |