NPI | 1235541699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13188) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1397) |
207Q00000X Family Medicine (Licence: WA MD60740444) | |
Enumeration Date | 2014-05-20 |
Last Update Date | 2023-12-15 |