NPI | 1619089679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD161618) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD20050308) |
207Q00000X Family Medicine (Licence: FL ME91522) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2016-11-21 |