| NPI | 1972796548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 45535) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 44999) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: KY 45535) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2022-11-03 |