| NPI | 1750585782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007864) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI DOS-1905) |
| 207Q00000X Family Medicine (Licence: NE 643) | |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-09-09 |