| NPI | 1417946674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 15858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000015858) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2023-03-22 |