| NPI | 1215191028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0052895) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 4071) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R8404) | |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2015-11-11 |