| NPI | 1750562047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 50459) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TN 50459) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2019-08-05 |