| NPI | 1639634926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 97360) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000070223) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2026-08-04 |