| NPI | 1598837031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-11017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101255431) |
| 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-34391) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2019-04-03 |