| NPI | 1659662930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4777) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 10236678) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2012-12-12 |