| NPI | 1619354420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 27968) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 3173) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2022-01-06 |