| NPI | 1124103445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO19146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A5511) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-08-05 |