| NPI | 1699156679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16953) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11018486A) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-08-24 |