| NPI | 1891723169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 20A6504) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3805) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2009-10-26 |