| NPI | 1710159694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 40458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 50997) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2022-12-02 |