NPI | 1174043517 |
---|---|
Former Name | MARIA CRUZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD200596) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11056) |
Enumeration Date | 2017-06-27 |
Last Update Date | 2022-07-21 |