| NPI | 1891923595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3519) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20a12984) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125056829) | |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2021-01-14 |