| NPI | 1306011994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A109632) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60095364) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2011-11-14 |