| NPI | 1275854093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4042) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10037206) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2018-12-13 |