| NPI | 1124373212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME126694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA a122965) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2022-12-19 |