| NPI | 1063862217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2019-0938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 267847) |
| 207Q00000X Family Medicine (Licence: IN 01079227A) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-08-01 |