| NPI | 1609869684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO1379) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TN 1379) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2025-12-03 |