| NPI | 1609947944 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 2035)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC SC 905)  | 
| Enumeration Date | 2006-11-10 | 
| Last Update Date | 2013-03-11 |