| NPI | 1174848121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 121825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 56735-20) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2013-11-14 |