| NPI | 1669852711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301509048)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01078959A)  | 
| Enumeration Date | 2015-06-04 | 
| Last Update Date | 2023-06-23 |