NPI | 1093169682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 62472) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 207Q0000X) |
Enumeration Date | 2016-04-20 |
Last Update Date | 2019-04-24 |