| NPI | 1013272988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 066927) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 51076) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 29375) | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2020-12-07 |