| NPI | 1245649474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO218800) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO5384) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2024-06-19 |