| NPI | 1295715985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO2251) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 1744) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2011-08-18 |