| NPI | 1518961135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD 26487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101230237) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2010-11-16 |