| NPI | 1104893155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-22734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 150671) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2024-02-29 |