NPI | 1417119348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: DE C1-0012985) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-01882) |
207Q00000X Family Medicine (Licence: MA 259345) | |
Enumeration Date | 2008-07-01 |
Last Update Date | 2022-06-15 |