| NPI | 1710986104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01077383A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 37089) |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-08-08 |