| NPI | 1972576080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01062309A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00043577) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2007-09-11 |