| NPI | 1255642856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 53402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME107543) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2021-07-22 |