NPI | 1194306639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MD D0098412) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10074825) |
207Q00000X Family Medicine (Licence: TX U2182) | |
Enumeration Date | 2021-04-16 |
Last Update Date | 2024-09-13 |