| NPI | 1659563641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A116562) |
| Additional Taxonomies | 174400000X Specialist |
| 207Q00000X Family Medicine (Licence: SC 32181) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2015-02-27 |