| NPI | 1366853640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101020949) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101020949) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2021-12-22 |