| NPI | 1962682765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 20141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS T-1852) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2017-05-11 |