| NPI | 1053631101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03468) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY 03468) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-03-01 |