| NPI | 1205891744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01043434A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 32413) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2020-12-15 |