| NPI | 1255433231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 17896) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN md0000037831) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2012-12-27 |