NPI | 1508018128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301093159) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014039905) |
Enumeration Date | 2008-10-14 |
Last Update Date | 2015-06-01 |