| NPI | 1912394743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO186153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG172036) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2021-03-25 |