NPI | 1316325384 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.144229) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD468437) |
207Q00000X Family Medicine (Licence: WA MD60828363) | |
Enumeration Date | 2015-05-11 |
Last Update Date | 2022-05-20 |