| NPI | 1396155644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI DOS-2310) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015800) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2023-01-12 |