NPI | 1578919239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 65697) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX S3709) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2022-06-21 |