NPI | 1407116593 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60772861) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD455283) |
Enumeration Date | 2012-05-22 |
Last Update Date | 2022-08-29 |