NPI | 1487281259 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD481762) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 71691) |
207Q00000X Family Medicine (Licence: DE C1-0026294) | |
207Q00000X Family Medicine (Licence: NJ 25MA11940200) | |
Enumeration Date | 2020-03-23 |
Last Update Date | 2023-09-03 |