NPI | 1912269135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60565046) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1248) |
Enumeration Date | 2012-06-13 |
Last Update Date | 2023-09-07 |