| NPI | 1164688644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-00540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A114475) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2013-01-09 |