NPI | 1063093011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77299) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 9006) |
Enumeration Date | 2021-04-20 |
Last Update Date | 2024-04-08 |