NPI | 1124202379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD C0001427) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01427) |
Enumeration Date | 2007-12-24 |
Last Update Date | 2021-08-20 |