| NPI | 1205097227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 62596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301104592) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2022-03-21 |