| NPI | 1417444845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 12857581) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT MED-RES-LIC-67437) |
| 207Q00000X Family Medicine (Licence: OR MD204302) | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2024-03-26 |