| NPI | 1821155623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A96306) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 12045) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2014-07-16 |