| NPI | 1306132543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D79750) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301098310) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301098310) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2018-12-17 |