NPI | 1154613735 |
---|---|
Other Name | LIS CAROL CRUZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0413) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 64163) |
207Q00000X Family Medicine (Licence: MI 4301098212) | |
Enumeration Date | 2011-05-13 |
Last Update Date | 2019-09-06 |