| NPI | 1184076242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10058108) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2019-04-15 |