| NPI | 1760988612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q3542) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61228529) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2025-02-25 |