| NPI | 1346532918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 47594) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 58997) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2015-09-22 |