| NPI | 1942357942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TN MD 27432) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: TN MD 27432) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-07-23 |