NPI | 1043715295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 102496) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 66429) |
Enumeration Date | 2018-03-29 |
Last Update Date | 2025-05-05 |