| NPI | 1376035105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 30526) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.159768) |
| 207Q00000X Family Medicine (Licence: KY 53785) | |
| 207Q00000X Family Medicine (Licence: ME MD26097) | |
| 207Q00000X Family Medicine (Licence: MI EMC0001876) | |
| 207Q00000X Family Medicine (Licence: NH 22953) | |
| 207Q00000X Family Medicine (Licence: TN 66079) | |
| 207Q00000X Family Medicine (Licence: WI 1956-320) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2022-08-31 |