| NPI | 1245891530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.145963) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351045650) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351045650) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.248147) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2023-11-03 |