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 |