| NPI | 1518965128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 23480) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 31945) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2023-07-25 |