| NPI | 1063054880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC 400001214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 400001214) |
| 207Q00000X Family Medicine (Licence: MO 2019034671) | |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2021-09-08 |