| NPI | 1356751143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: TX Q5836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q5836) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10049933) | |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2021-06-18 |