| NPI | 1598212441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V3006) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 14,240-I) |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2024-08-08 |