NPI | 1174935720 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60893531) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP03097) |
Enumeration Date | 2014-05-29 |
Last Update Date | 2019-02-07 |