| NPI | 1386094332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL0007687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT017419) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2019-11-19 |