| NPI | 1225365208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P2487) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57-016811) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2021-05-25 |