NPI | 1750662813 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 65836) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 57789) |
Enumeration Date | 2011-09-02 |
Last Update Date | 2021-12-02 |