| NPI | 1275849903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20a12939) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS 11003) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2016-12-02 |