| NPI | 1912183971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-15451) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 23375) |
| Enumeration Date | 2008-01-21 |
| Last Update Date | 2023-07-24 |