| NPI | 1215916200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A8712) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 225413) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2008-09-11 |