NPI | 1144596313 |
---|---|
Former Name | ELIZABETH RENAE ANGSTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4358) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60488525) |
Enumeration Date | 2012-03-31 |
Last Update Date | 2024-07-11 |