NPI | 1487901781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME160353) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R2166) |
207Q00000X Family Medicine (Licence: PA MT202828) | |
Enumeration Date | 2012-08-07 |
Last Update Date | 2023-09-26 |