NPI | 1497012025 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D86664) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 278254) |
Enumeration Date | 2012-04-20 |
Last Update Date | 2022-10-11 |