| NPI | 1801059332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 42964) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD46507) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2025-10-17 |