NPI | 1285020040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0087793) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MD D87793) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-04-08 |
Last Update Date | 2020-10-12 |