NPI | 1700379187 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020918) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018524) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2021-10-13 |