NPI | 1811900608 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338725) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA05621900) |
207Q00000X Family Medicine (Licence: FL ME148626) | |
Enumeration Date | 2006-08-14 |
Last Update Date | 2023-12-28 |