NPI | 1114128964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 57009475) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 249074-1) |
Enumeration Date | 2007-05-30 |
Last Update Date | 2017-03-01 |