NPI | 1770877656 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102204231) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP1-0039555) |
Enumeration Date | 2011-06-08 |
Last Update Date | 2017-04-28 |