| NPI | 1417337965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 64835) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 29530) |
| Enumeration Date | 2015-05-30 |
| Last Update Date | 2022-06-07 |