| NPI | 1174616288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 52146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0068654) |
| 207Q00000X Family Medicine (Licence: WV 19562) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-12-12 |