| NPI | 1902192008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 51639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL33728) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2022-03-28 |