NPI | 1003349648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 320516) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S1536) |
Enumeration Date | 2017-04-11 |
Last Update Date | 2021-10-25 |