| NPI | 1871780445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A115972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT189962) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2014-11-10 |