| NPI | 1073953964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61486368) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02004525A) |
| 207Q00000X Family Medicine (Licence: HI DOS2187) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2025-04-02 |