| NPI | 1538505276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-12654) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A125780) |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2016-11-17 |