| NPI | 1669645404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 46853) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 46853) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2019-04-08 |