| NPI | 1699201681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD61947) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME142502) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-09-16 |