| NPI | 1669415857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A78856) |
| Additional Taxonomies | 171W00000X Contractor (Licence: CA A78856) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2012-03-28 |