| NPI | 1912168022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 306928) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01068104A) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2020-10-08 |