| NPI | 1386620185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C53639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 40192) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2012-01-11 |