| NPI | 1407980634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 25457) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 45975) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-07-09 |