| NPI | 1205152964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P6704) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 390200000X) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2023-01-09 |