| NPI | 1518252477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A13492) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OT014171) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2014-11-11 |