| NPI | 1760450308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO157587) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 02002996A) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2012-08-07 |