| NPI | 1699089268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A13639)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 274346-134)  | 
| Enumeration Date | 2010-08-05 | 
| Last Update Date | 2015-03-13 |