| NPI | 1740500149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL me115938) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10038531) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2021-07-19 |