NPI | 1285954867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.206003) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT197201) |
Enumeration Date | 2010-06-07 |
Last Update Date | 2019-08-21 |