| NPI | 1144671082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101024622) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101022524) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2019-05-15 |