NPI | 1154705895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R8011) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A157072) |
207Q00000X Family Medicine (Licence: FL ME162177) | |
Enumeration Date | 2015-07-13 |
Last Update Date | 2024-05-03 |