| NPI | 1639225220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 54329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 47914) |
| 207Q00000X Family Medicine (Licence: CA A106783) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-09-12 |