NPI | 1568719425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME128949) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL 34976) |
Enumeration Date | 2012-08-10 |
Last Update Date | 2021-12-08 |