| NPI | 1780096842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: TX R2177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R2177) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10051249) | |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2021-11-02 |