| NPI | 1902074644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101248386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A73656) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2011-07-26 |