| NPI | 1033565395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-42524) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A150575) |
| 207Q00000X Family Medicine (Licence: NV 20609) | |
| 207Q00000X Family Medicine (Licence: OK 34798) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2021-08-09 |