| NPI | 1316504350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036.171361) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 13580) |
| 207Q00000X Family Medicine (Licence: TX T7768) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: BP10068878) | |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-10-29 |