| NPI | 1376077719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL os16163) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL b642423896900) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2020-07-28 |