NPI | 1578620308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: TX L9011) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L9011) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2022-07-23 |