NPI | 1386022630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN DO4807) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 117-T2) |
207Q00000X Family Medicine (Licence: VA 0102207261) | |
Enumeration Date | 2015-05-07 |
Last Update Date | 2023-06-02 |