| NPI | 1609347814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 25254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN281768) |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-18 |