| NPI | 1144665316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-59169) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60633045) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-02-10 |