NPI | 1821356684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35142345) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 61704) |
207Q00000X Family Medicine (Licence: MI 4301108646) | |
Enumeration Date | 2012-04-30 |
Last Update Date | 2021-09-15 |