NPI | 1184615817 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101236864) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 21701) |
Enumeration Date | 2005-11-02 |
Last Update Date | 2023-05-09 |