| NPI | 1235484189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 322103) |
| Additional Taxonomies | 207QG0300X Family Medicine Geriatric Medicine (Licence: LA 322103) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10041034) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2020-10-15 |