| NPI | 1215939277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD 17490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101044646) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2011-10-21 |