NPI | 1699406652 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0103765) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT227172) |
Enumeration Date | 2022-06-21 |
Last Update Date | 2025-09-08 |