| NPI | 1750516340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0112202707) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 2OA10424) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2012-08-14 |