NPI | 1962481549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV WV1479) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34006319) |
207Q00000X Family Medicine (Licence: KS 05-48660) | |
Enumeration Date | 2006-01-12 |
Last Update Date | 2024-10-09 |