| NPI | 1235423443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 21934) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60357363) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA ML60224959) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-12-07 |