| NPI | 1710962113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A96265) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 36443) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IA 36443) | |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2014-10-09 |