| NPI | 1295054617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 03496) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 3133) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2018-03-17 |