NPI | 1639631260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 47896) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 47279) |
Enumeration Date | 2019-04-02 |
Last Update Date | 2023-01-31 |