NPI | 1578149043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 103804) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN33656) |
207Q00000X Family Medicine (Licence: FL ME158822) | |
Enumeration Date | 2021-03-23 |
Last Update Date | 2025-05-12 |