| NPI | 1639583404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 94-08383) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01078091A) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2023-08-10 |