NPI | 1629182159 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME171380) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A92316) |
207Q00000X Family Medicine (Licence: OH 35.122355) | |
Enumeration Date | 2006-08-19 |
Last Update Date | 2025-01-13 |