NPI | 1679925127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 22151) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 32875-R) |
207Q00000X Family Medicine (Licence: TX S2655) | |
Enumeration Date | 2016-07-08 |
Last Update Date | 2022-12-06 |