| NPI | 1659831709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 59970) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01087912A) |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2025-06-20 |