| NPI | 1013123371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 32866) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT190771) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-05-20 |