| NPI | 1417217456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-20014) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2014-00747) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 182477) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2021-05-12 |