NPI | 1215382197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A160364) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA10440600) |
207QA0000X Family Medicine, Adolescent Medicine (Licence: CA A160364) | |
207QA0505X Family Medicine, Adult Medicine (Licence: CA A160364) | |
Enumeration Date | 2016-04-28 |
Last Update Date | 2023-12-20 |