NPI | 1124413612 |
---|---|
Former Name | SOFIA MARTINEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01086080A) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018031630) |
Enumeration Date | 2015-04-01 |
Last Update Date | 2021-12-01 |