| NPI | 1508012741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 17590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 117842) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2016-07-13 |