NPI | 1396893491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6217) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 55090) |
207Q00000X Family Medicine (Licence: WA MD00045583) | |
Enumeration Date | 2007-01-08 |
Last Update Date | 2014-01-17 |