| NPI | 1124149869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34-009351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101016706) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-12-27 |