| NPI | 1316150022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD 27394) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR MD27394) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA A97048) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2013-08-08 |