| NPI | 1164466827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 47644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 38090) |
| 207Q00000X Family Medicine (Licence: OH 35082925) | |
| 207Q00000X Family Medicine (Licence: NC 200701334) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-02-20 |