| NPI | 1215065867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 42541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 23188) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-03-18 |