| NPI | 1275739781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 43863) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301090507) |
| 207Q00000X Family Medicine (Licence: MI 4301090507) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2023-01-04 |