| NPI | 1912983313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G074754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G74754) |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2015-03-31 |