NPI | 1679239206 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: DC PA200001327) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110008232) |
Enumeration Date | 2021-11-09 |
Last Update Date | 2024-07-02 |