| NPI | 1205495736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-48216) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11511) |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2022-11-07 |