| NPI | 1912640897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD227754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD.MD.70047463) |
| 207Q00000X Family Medicine (Licence: TX V1474) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2026-07-09 |