| NPI | 1336305622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD038513) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11013083A) | 
| Enumeration Date | 2008-08-06 | 
| Last Update Date | 2012-11-15 |