| NPI | 1750487765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CA 20A5075) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 20A5075) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |