| NPI | 1861732968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO3035) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL1700) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2021-03-08 |