| NPI | 1972122174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U6225) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11021016A) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2023-08-31 |