| NPI | 1386022630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO4807) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102207261) |
| 207Q00000X Family Medicine (Licence: WY 117-T2) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2026-06-02 |