| NPI | 1265506794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A34653) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A34653) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2014-10-22 |