| NPI | 1225120892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A102024) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 46409) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2010-10-20 |