| NPI | 1063635522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 01012685144) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: CO 48080) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-01-20 |