| NPI | 1578557690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 1.079229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD20666) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2024-09-16 |