| NPI | 1356667273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 12383446-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-133164) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2022-11-18 |