NPI | 1164694634 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P2852) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 8800) |
207Q00000X Family Medicine (Licence: AK 6418) | |
Enumeration Date | 2008-03-25 |
Last Update Date | 2013-05-03 |