| NPI | 1811164098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A113922) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: LA MD204585) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2011-07-06 |