| NPI | 1720006067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C52665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 45780) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2010-11-16 |