| NPI | 1205231032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4475) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 285988) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2021-04-12 |