| NPI | 1154901221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 303102123) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 123456) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-04-15 |