NPI | 1538146105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME125308) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 43363) |
207Q00000X Family Medicine (Licence: TX N1248) | |
Enumeration Date | 2005-12-27 |
Last Update Date | 2021-11-23 |