| NPI | 1730176546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD22425) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 37907) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2020-11-10 |