| NPI | 1639874928 |
|---|---|
| Former Name | CELESTE BODUCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX w5317) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2026-05-20 |