NPI | 1942520424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101018730) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 268963) |
Enumeration Date | 2010-06-07 |
Last Update Date | 2023-03-13 |