NPI | 1790191732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 62703) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10115) |
Enumeration Date | 2014-07-10 |
Last Update Date | 2020-12-21 |