| NPI | 1386840643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P2012) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: MI 5101017481) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2021-05-20 |