| NPI | 1619931581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 1432) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 057348) |
| 207Q00000X Family Medicine (Licence: TN 1949) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2020-12-04 |