| NPI | 1750843637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 98646) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 65954) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2025-02-25 |