| NPI | 1366616955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 246820) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301091560) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301091560) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2016-06-27 |