| NPI | 1104212844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.38620) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 574113) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2019-10-16 |