| NPI | 1134772882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 39216) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 309446) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2022-06-29 |