| NPI | 1407951494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 54505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME102532) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MN 54505) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-02-29 |