| NPI | 1750473039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 29730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 322043) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2013-10-28 |