| NPI | 1235368861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10038538) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116021220) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2016-05-11 |