| NPI | 1972597656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 54207) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 47166) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2015-02-19 |