| NPI | 1679276018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA DO.OP.70075876) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: TX V6421) | |
| Enumeration Date | 2023-03-24 |
| Last Update Date | 2026-07-30 |