NPI | 1700378148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY C1119) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2231) |
Enumeration Date | 2018-06-01 |
Last Update Date | 2022-11-08 |