| NPI | 1245577279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A13851) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116025434) |
| Enumeration Date | 2013-01-10 |
| Last Update Date | 2016-01-18 |