| NPI | 1932355310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A104868) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A104868) |
| 208000000X Pediatrics (Licence: CA A104868) | |
| 207R00000X Internal Medicine (Licence: CA A104868) | |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2013-10-31 |