NPI | 1790262210 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 19474) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020971) |
207Q00000X Family Medicine (Licence: PA OT018886) | |
Enumeration Date | 2018-07-26 |
Last Update Date | 2022-07-01 |