| NPI | 1902035371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 48981) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301094065) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2016-03-08 |