| NPI | 1306379342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.137471) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 12244) |
| 207Q00000X Family Medicine (Licence: WI 77112) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-01-31 |