NPI | 1376956466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R1723) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102204318) |
207Q00000X Family Medicine (Licence: MI 5101022945) | |
Enumeration Date | 2014-06-05 |
Last Update Date | 2024-10-24 |