| NPI | 1063619518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD194544) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1496) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NH RT1676) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2021-09-29 |