NPI | 1295227460 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301510432) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101273387) |
207Q00000X Family Medicine (Licence: PA MT215117) | |
Enumeration Date | 2018-06-04 |
Last Update Date | 2024-05-21 |