| NPI | 1295830701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 63931) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 29280) |
| 207Q00000X Family Medicine (Licence: CA A113594) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2014-01-21 |