NPI | 1326309121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME164822) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 074554) |
207Q00000X Family Medicine (Licence: SC LL34544) | |
Enumeration Date | 2012-06-07 |
Last Update Date | 2024-03-22 |