| NPI | 1205825866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 40253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD40253) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2016-04-11 |