| NPI | 1669017117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 10002851A) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2021-08-24 |