| NPI | 1225314131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 57440-20) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 57440-20) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 3928-850) | |
| 207Q00000X Family Medicine (Licence: IA 41109) | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2018-09-21 |