| NPI | 1407342975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 6323) |
| Enumeration Date | 2018-07-07 |
| Last Update Date | 2019-05-08 |