NPI | 1063909711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: KS 04-46667) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208D00000X General Practice (Licence: MO 2018017386) | |
Enumeration Date | 2018-04-18 |
Last Update Date | 2022-11-02 |