| NPI | 1346242302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD 12540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101036430) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2009-09-23 |