| NPI | 1801214879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61031956) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R3958) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: 0) | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2021-11-19 |