| NPI | 1255785903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 38302) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 32352) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2019-08-30 |