| NPI | 1093041659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101018189) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 14181) |
| 208D00000X General Practice (Licence: MI 5101018189) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2021-03-23 |