| NPI | 1992796650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00047267) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01055784) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2021-05-12 |