| NPI | 1093076945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 79110) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-17319) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2025-01-16 |