NPI | 1679102412 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V6592) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 313979) |
Enumeration Date | 2020-04-03 |
Last Update Date | 2025-04-01 |