| NPI | 1669472783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 14685) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 017986) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2023-03-07 |