| NPI | 1366737686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-40423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-9275) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2019-09-28 |