| NPI | 1164746970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 287622) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 46192) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2019-09-13 |