| NPI | 1932510542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2017-0266) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0291) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2017-08-10 |