| NPI | 1902169691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 2912) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT014599) |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2015-11-11 |