| NPI | 1245407634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60279939) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11014598) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2021-05-18 |