NPI | 1598102394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A135827) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 284465-1) |
Enumeration Date | 2013-06-03 |
Last Update Date | 2021-03-10 |