| NPI | 1417213489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 39824) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.126659) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: SC LL39824) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-07-21 |