| NPI | 1811554108 | 
|---|---|
| Former Name | SERENA LAWRENCE MCGILL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T7524) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10068874) | 
| Enumeration Date | 2019-05-22 | 
| Last Update Date | 2022-06-21 |