| NPI | 1790428217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10079998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V2493) |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2024-09-11 |