| NPI | 1033663919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 21142) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 14187-I) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PR 33817R) | |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2020-06-01 |