NPI | 1033564141 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 149626) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 60134) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-26 |
Last Update Date | 2024-05-15 |