| NPI | 1174915680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2018-01569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 58.005890) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2018-07-18 |