| NPI | 1790197416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 24203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 61110) |
| 207Q00000X Family Medicine (Licence: AL L.4005R) | |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2024-03-22 |