NPI | 1457571408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME135090) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-00415) |
207Q00000X Family Medicine (Licence: VA 0101258088) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2018-06-12 |