| NPI | 1376108134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS23077) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 81299) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: AZ 009666) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2026-05-06 |