NPI | 1770965220 |
---|---|
Other Name | TINA LY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C186952) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.133672) |
207Q00000X Family Medicine (Licence: WV 30002) | |
Enumeration Date | 2015-06-22 |
Last Update Date | 2023-09-11 |