NPI | 1104143072 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 7867) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 54140) |
Enumeration Date | 2010-04-30 |
Last Update Date | 2015-10-14 |