| NPI | 1164685103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101246060) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116020626) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2021-11-30 |