| NPI | 1073074076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: AZ 009249) |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine (Licence: TX BP10081498) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-31 |
| Last Update Date | 2023-09-19 |