NPI | 1912072455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0000X Family Medicine, Adolescent Medicine (Licence: CT 033793) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 033793) |
Enumeration Date | 2006-11-21 |
Last Update Date | 2007-07-08 |