| NPI | 1174784300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0116018858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A106157) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2013-08-20 |