| NPI | 1780033639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-45099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10563) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2020-01-14 |