NPI | 1134689995 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61180673) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML6092130) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2025-01-08 |