NPI | 1376868224 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60394364) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL1418) |
207Q00000X Family Medicine (Licence: ID O-0662) | |
Enumeration Date | 2010-04-05 |
Last Update Date | 2021-07-01 |