| NPI | 1033312442 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 02004512A)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036129571)  | 
| 207Q00000X Family Medicine (Licence: MI 5101016722)  | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101016722)  | |
| Enumeration Date | 2007-06-06 | 
| Last Update Date | 2022-10-03 |