| NPI | 1073780342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101263202) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01065000A) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2021-03-01 |