| NPI | 1215617477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 34283) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TN 34283) |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2024-03-13 |