NPI | 1972549970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2011-0759) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MD16115) |
207Q00000X Family Medicine (Licence: NC 9701248) | |
Enumeration Date | 2006-06-20 |
Last Update Date | 2024-08-26 |