NPI | 1306379441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 68432) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 227663) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-04-05 |
Last Update Date | 2024-07-02 |