| NPI | 1053479139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000024370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101049268) |
| 207Q00000X Family Medicine (Licence: NC 35148) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |