| NPI | 1063087310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61576600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1234) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2024-07-26 |