| NPI | 1023115664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 0106437A) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2023-08-07 |