| NPI | 1770596678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 4689) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9400) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2013-02-18 |