| NPI | 1538626478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 13966152-1205) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 34359-R) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14752) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 21934) | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2025-02-18 |