| NPI | 1366401572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G70385) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G070385) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2012-03-05 |