| NPI | 1487671350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD0000016150) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN MD0000016150) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2011-10-11 |