| NPI | 1134571763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 4067) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10603) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2020-07-16 |