NPI | 1992968853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137622) |
Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: VA 89982967) |
207Q00000X Family Medicine (Licence: VA 0116019794) | |
Enumeration Date | 2008-07-09 |
Last Update Date | 2019-03-10 |