NPI | 1952560179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60588585) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 13993) |
Enumeration Date | 2008-06-03 |
Last Update Date | 2015-10-08 |