NPI | 1255565990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036121954) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 54207-020) |
207Q00000X Family Medicine (Licence: CA A114049) | |
207Q00000X Family Medicine (Licence: NJ 25MA09568100) | |
Enumeration Date | 2009-05-10 |
Last Update Date | 2016-12-05 |