| NPI | 1154052397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2025-01539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11022499A) |
| Enumeration Date | 2022-06-20 |
| Last Update Date | 2025-08-12 |