NPI | 1558654020 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.133520) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN MD0000050361) |
Enumeration Date | 2011-05-17 |
Last Update Date | 2023-11-07 |