| NPI | 1912973843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G44064) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301041199) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-04-25 |