NPI | 1902904345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60428736) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 220410) |
207Q00000X Family Medicine (Licence: LA 14297R) | |
207Q00000X Family Medicine (Licence: AK 5802) | |
Enumeration Date | 2006-09-20 |
Last Update Date | 2019-02-07 |