NPI | 1407204225 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13950) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1587) |
207Q00000X Family Medicine (Licence: NE 31592) | |
Enumeration Date | 2016-06-02 |
Last Update Date | 2023-12-15 |