| NPI | 1952592560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C41033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 85-215) |
| 207Q00000X Family Medicine (Licence: TX G3497) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |