| NPI | 1083950661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.143190) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301105347) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-12-30 |
| Last Update Date | 2022-08-10 |