| NPI | 1194925487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN Do0000002370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS013484) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2017-02-01 |