| NPI | 1669584835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-02435) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A8528) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-02-09 |