| NPI | 1831190628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME76480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A81881) |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2011-11-29 |