| NPI | 1164722468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 87303) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2021-09-09 |