| NPI | 1710115399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T5190) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A11620) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: OR DO156881) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2022-08-04 |