| NPI | 1023690385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W0263) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX W0263) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2025-09-11 |