| NPI | 1962623538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A102553) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301084039) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2014-07-24 |