NPI | 1861865339 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: LA RN127826) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: LA AP08483) |
Enumeration Date | 2015-11-05 |
Last Update Date | 2024-04-04 |