| NPI | 1255630604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01073377A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-124156) |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2020-06-15 |