NPI | 1194808923 |
---|---|
Former Name | JUDITH ADELA MENJIVAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G058720) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G58720) |
Enumeration Date | 2006-10-23 |
Last Update Date | 2022-10-29 |