NPI | 1417979535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD446384) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042-0009417) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2018-03-28 |