NPI | 1750458964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD162119) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 36168) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2015-02-19 |