| NPI | 1619358694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018475A) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-08-31 |