| NPI | 1619402484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-14433) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1638) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2021-09-21 |