| NPI | 1003063314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD051739) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 2538) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2022-03-16 |