| NPI | 1750368726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02976) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02001458) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2023-03-15 |