| NPI | 1073196283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-16865) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-2025) |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2024-08-30 |