NPI | 1558824011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99224) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U2762) |
Enumeration Date | 2019-04-11 |
Last Update Date | 2024-08-22 |