| NPI | 1720073521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: IN 01061215A) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IN 01061215A) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2013-10-23 |