| NPI | 1720089329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A55639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 43833) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2010-12-02 |