| NPI | 1437196151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA G38567) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G38567) |
| 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA G38567) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-08-05 |