| NPI | 1972913994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2017-0762) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0350) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2024-10-17 |