NPI | 1356348718 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 86734) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301069503) |
207Q00000X Family Medicine (Licence: OH 35-078484) | |
Enumeration Date | 2005-06-30 |
Last Update Date | 2023-04-20 |