NPI | 1497109755 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 69806) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VT 042.0014507) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2022-09-13 |