| NPI | 1942430111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN MD50520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101252158) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2020-11-12 |