NPI | 1215386800 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 78755) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TPME4914) |
207Q00000X Family Medicine (Licence: IL 036167275) | |
Enumeration Date | 2016-06-06 |
Last Update Date | 2025-01-14 |