NPI | 1780065342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME160256) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 31477) |
207Q00000X Family Medicine (Licence: TX BP10051981) | |
Enumeration Date | 2015-06-09 |
Last Update Date | 2025-03-20 |