| NPI | 1184601783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G61669) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 18881) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2011-08-25 |