NPI | 1164643664 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD159972) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 0420011763) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2021-03-29 |