| NPI | 1326215120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 47586) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 066297) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2011-07-13 |