| NPI | 1013470178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301512811) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T5014) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2025-01-24 |