NPI | 1033634407 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-50168) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME134954) |
207Q00000X Family Medicine (Licence: GA 7501) | |
Enumeration Date | 2017-08-07 |
Last Update Date | 2024-01-23 |