| NPI | 1134313265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO2150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-01172) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2012-02-02 |