NPI | 1629068127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 239601) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 41521) |
Enumeration Date | 2005-10-26 |
Last Update Date | 2013-06-21 |