| NPI | 1306981741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD55751) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 241709) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-06-25 |