NPI | 1366431645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-40064) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101259752) |
207Q00000X Family Medicine (Licence: IN 1056447A) | |
Enumeration Date | 2005-10-19 |
Last Update Date | 2022-07-21 |