| NPI | 1164652202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A98430) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101247155) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2011-10-26 |