| NPI | 1154950483 |
|---|---|
| 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: MN 71609) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2023-12-07 |