NPI | 1720049612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME108708) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47629-020) |
Enumeration Date | 2006-03-30 |
Last Update Date | 2023-05-04 |