NPI | 1679685150 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 193200000X Multi-Specialty (Licence: WV 21188) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 21188) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2015-09-22 |