| NPI | 1972232940 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10081425) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U7288) | 
| Enumeration Date | 2022-06-06 | 
| Last Update Date | 2023-11-29 |