| NPI | 1225294176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34010291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101019618) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.002536) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2020-11-23 |