| NPI | 1689830093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60614801) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01072603A) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2021-06-18 |