| NPI | 1730217381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 67858) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 42252) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2022-01-18 |