| NPI | 1629008339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A84474) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A84474) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2015-11-04 |