NPI | 1114419645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD H091237) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018468) |
Enumeration Date | 2018-05-31 |
Last Update Date | 2021-07-14 |