NPI | 1255422598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME103322) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23848) |
207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME103322) | |
Enumeration Date | 2006-09-28 |
Last Update Date | 2020-05-21 |