| NPI | 1760125751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V6661) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD486736) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2025-11-21 |