NPI | 1942297395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101239406) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200200904) |
Enumeration Date | 2005-09-30 |
Last Update Date | 2008-01-22 |