NPI | 1518225564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102204145) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 2982) |
Enumeration Date | 2012-04-27 |
Last Update Date | 2022-08-23 |