| NPI | 1821483942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME-146004) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-19703) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2021-02-18 |