| NPI | 1306848619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02003956A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101007658) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2018-03-17 |