NPI | 1093542110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV APRN120792) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP030143) |
Enumeration Date | 2024-09-14 |
Last Update Date | 2024-10-08 |