NPI | 1326493289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01311) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 58464) |
207Q00000X Family Medicine (Licence: WA MD61422193) | |
Enumeration Date | 2016-04-28 |
Last Update Date | 2024-09-09 |