| NPI | 1639355076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C134740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD429612) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2015-06-18 |