NPI | 1790015766 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD 60193720) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 25754) |
Enumeration Date | 2010-01-13 |
Last Update Date | 2020-07-30 |