| NPI | 1770961336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T8385) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 50559) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 50559) | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2022-10-06 |