NPI | 1619358074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 61034) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 103081) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2025-08-29 |