| NPI | 1255568515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO159382) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1636) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10033765) | |
| Enumeration Date | 2009-06-14 |
| Last Update Date | 2020-07-08 |