| NPI | 1003070921 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39219)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R8274)  | 
| Enumeration Date | 2008-07-10 | 
| Last Update Date | 2023-12-26 |