| NPI | 1720188956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301072875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01061418A) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-06-09 |