| NPI | 1295022036 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME153100)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072864A)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11016301A)  | |
| Enumeration Date | 2011-06-30 | 
| Last Update Date | 2022-02-23 |