| NPI | 1932542594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 22902) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 505502) |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2013-04-14 |