| NPI | 1215165311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 48941) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 38170) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2018-04-23 |