NPI | 1740205780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 55955) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-11164) |
207Q00000X Family Medicine (Licence: CA C54747) | |
207Q00000X Family Medicine (Licence: CO 0055110) | |
Enumeration Date | 2006-07-12 |
Last Update Date | 2020-02-03 |