NPI | 1811564057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD218627) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116035317) |
Enumeration Date | 2021-06-07 |
Last Update Date | 2024-09-30 |