| NPI | 1659759108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 26539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 58334) |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2024-03-05 |