| NPI | 1265667141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 40053) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10034837) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2015-05-13 |