NPI | 1316328875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 18262) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 18262) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA OT016411) | |
Enumeration Date | 2015-06-10 |
Last Update Date | 2022-01-10 |