| NPI | 1144485947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD 16247) |
| 207Q00000X Family Medicine (Licence: WY 8599A) | |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2012-09-27 |