NPI | 1689907024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD D0060307) |
Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: VA 0101235327) |
Enumeration Date | 2009-09-17 |
Last Update Date | 2009-09-17 |