NPI | 1770681405 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 346000) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.5581VP) |
207Q00000X Family Medicine (Licence: NC 2015-02190) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2025-04-09 |