| NPI | 1982950630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C53174) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000042671) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2012-07-31 |