| NPI | 1366670861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61035183) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0101259547) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2020-05-22 |