| NPI | 1700982493 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A67871)  | 
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA A67871)  | 
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CA A67871)  | |
| Enumeration Date | 2006-09-16 | 
| Last Update Date | 2008-02-13 |