| NPI | 1003238940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 27664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101257167) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2015-01-26 |