| NPI | 1114260106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D86458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 27045) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2019-01-31 |