| NPI | 1962576330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01072716A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA07534400) |
| 207Q00000X Family Medicine (Licence: WI 50765) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2021-11-30 |