| NPI | 1275530222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 56879) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 35793) |
| 207Q00000X Family Medicine (Licence: MO 2009010545) | |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2018-03-17 |