| NPI | 1871518951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 057042) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A102071) |
| 207Q00000X Family Medicine (Licence: MS 19333) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2014-09-15 |