NPI | 1912293739 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 992) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.060210) |
Enumeration Date | 2011-06-20 |
Last Update Date | 2014-07-22 |