NPI | 1033645189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-46492) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10812) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2020-08-24 |