NPI | 1720434103 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 62909) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 62909) |
Enumeration Date | 2016-05-04 |
Last Update Date | 2024-07-31 |