| NPI | 1295907525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N8612) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301090402) |
| 207Q00000X Family Medicine (Licence: WI 53373-20) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101247080) | |
| Enumeration Date | 2008-03-26 |
| Last Update Date | 2016-08-22 |