NPI | 1023544871 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 86815) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TN 61985) |
207QA0505X Family Medicine, Adult Medicine (Licence: AL 38347) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2020-11-10 |