| NPI | 1659466969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G36982) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: WA MD00018121) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-02-28 |