| NPI | 1295261592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T1521) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 227449) |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2021-08-31 |