| NPI | 1306103684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60547902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q8850) |
| 207Q00000X Family Medicine (Licence: TX 45215) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2019-05-01 |