| NPI | 1336568252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2016-0857) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 119176) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2014-0395) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2017-05-19 |