| NPI | 1386794220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME80408) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G70192) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2007-07-08 |