| NPI | 1396388740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R78331) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019038350) |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2020-07-15 |