NPI | 1144755323 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 64225) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301501881) |
Enumeration Date | 2017-04-26 |
Last Update Date | 2022-04-13 |