NPI | 1972577286 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME172671) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C151203) |
207Q00000X Family Medicine (Licence: TX K2699) | |
Enumeration Date | 2006-02-14 |
Last Update Date | 2025-06-30 |