| NPI | 1285121558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T2470) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10063188) |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2025-12-09 |