| NPI | 1205268810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 33979) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 2243) |
| 207Q00000X Family Medicine (Licence: TN 67142) | |
| 207Q00000X Family Medicine (Licence: GA 94101) | |
| 207Q00000X Family Medicine (Licence: LA 334736) | |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2026-05-29 |