NPI | 1104454735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 75999) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 8555) |
Enumeration Date | 2020-03-30 |
Last Update Date | 2023-07-05 |