| NPI | 1235691445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 70180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2023-0225) |
| 207Q00000X Family Medicine (Licence: OR MD212329) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-06-06 |