NPI | 1891904645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: WI 64483) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 64483) |
208D00000X General Practice (Licence: NC 2006-01268) | |
Enumeration Date | 2007-05-21 |
Last Update Date | 2022-11-18 |