| NPI | 1720112204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A72434) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 29361) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2013-08-09 |