| NPI | 1073805461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101255807) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116023296) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2017-01-05 |