| NPI | 1679501878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01037340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 25895) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2015-02-16 |